Thursday, May 15, 2014

[May 20 update: The current list of sign ons has gone up to 116 - and the list below the letter reflects the new number. Organizations - and now individuals as well - are invited to sign on here.]

PrEP is a powerful, additional tool in the AIDS response

Thursday, May 15, 2014 — A group of 69 82 116 leading HIV/AIDS and health organizations HIV/AIDS and health organizations and allies today reiterated their strong support for oral pre-exposure prophylaxis (PrEP) as an important HIV prevention strategy for men and women at risk of HIV infection. The diverse group of advocates, researchers and service providers hailed new HIV PrEP guidelines from the US Centers for Disease Control and Prevention (CDC) as a science-driven, public health approach to what remains a major health crisis in the United States.

The guidelines come almost two years after the US Food and Drug Administration (FDA) approved the oral drug Truvada (TDF/FTC) for HIV prevention following an extensive review of data from multiple, multinational clinical trials of PrEP among men and women with different risks for HIV infection. In the time since FDA approval, the CDC has reviewed additional data and sought input from a range of experts and community members to develop these new guidelines.

The guidelines provide critical information to help healthcare providers and patients evaluate the suitability of oral PrEP as an HIV prevention option and ensure that those who choose PrEP have the support – including ongoing monitoring, counseling, adherence support and frequent HIV and STD testing – necessary for PrEP to be effective.

The group strongly condemns the harmful misrepresentations of the facts and anti-scientific approach to PrEP adopted by the AIDS Healthcare Foundation and its president Michael Weinstein. Weinstein continues to make assertions that are not grounded in scientific evidence. We reject statements from all quarters that add to the deep stigma attached to HIV and that erect barriers between people and what they can use to support their health.

Weinstein’s statement that widespread use of PrEP will be accompanied by “a shift to condomless sex” is not based on evidence. In fact, initial studies suggest the opposite, and Weinstein’s assertion underestimates the capacity of informed individuals to make decisions about their health and sex lives. We all must do more to reinvigorate the approach to correct and consistent condom use and underscore that PrEP and condoms are complimentary interventions to the prevention of all STDs, including HIV. But Weinstein's statements fail to recognize that many adults – in the United States and across the world – have not been using condoms consistently or correctly for a host of reasons. PrEP now provides an additional option that also provides significant protection against HIV.

The current scientific evidence clearly indicates that PrEP, when taken daily as directed, can reduce the risk of HIV infection by more than 90 percent. CDC’s PrEP guidelines, like public health guidelines aimed at helping prevent other diseases, outline the support needed to help patients adhere to the daily dosing. The idea of taking a daily pill for prevention is not new: millions of women have successfully taken contraceptive pills to prevent unintended pregnancy, and men and women are able to take a variety of medications to treat or prevent a range of health issues.

The CDC PrEP guidelines underscore that PrEP is not for everyone. Neither CDC nor any of our organizations are advocating for indiscriminate use of PrEP. Neither is anyone suggesting that oral PrEP is a replacement for condoms; rather it is an additional option from which individuals should be able to choose.

PrEP has the potential to help many individuals in the US and around the world protect themselves from HIV. Failure to strategically, effectively and responsibly implement this scientifically sound strategy as part of comprehensive prevention and treatment programs in our fight against HIV would be a true catastrophe. We support the CDC guidelines, and, more importantly, we support the right of informed adults to choose the most appropriate mix of HIV prevention options for their lives as part of truly comprehensive approaches to testing, treatment, care and prevention.

What is PrEP?

Pre-Exposure Prophylaxis, or PrEP, is a new HIV prevention strategy in which HIV-negative people use HIV antiretrovirals (ARVs), drugs usually used to treat HIV infection, to reduce their risk of becoming infected with HIV.

Trials among gay men, other men who have sex with men, transgender women, heterosexuals, and injection drug users have shown that PrEP can reduce HIV infection risk quite significantly – especially when PrEP is taken consistently, and if other safer sex strategies are used as well.